Provider Demographics
NPI:1588920342
Name:PHYSIO, INC.
Entity type:Organization
Organization Name:PHYSIO, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:240-291-1429
Mailing Address - Street 1:640 MERRIMON AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3456
Mailing Address - Country:US
Mailing Address - Phone:828-348-1780
Mailing Address - Fax:877-922-4820
Practice Address - Street 1:640 MERRIMON AVE STE 107
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-3456
Practice Address - Country:US
Practice Address - Phone:828-348-1780
Practice Address - Fax:877-922-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP13545261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy